Eyeworld

8 | EYEWORLD BONUS ISSUE | FEBRUARY 2025 G UCOMA by Manjool Shah, MD Glaucoma Editor The evolving glaucoma space I t really seems like glauco- ma is everywhere. It was not that long ago when all ophthalmologists managed glaucoma with topical therapy, but only a few glau- coma specialists (gluttons for punishment) actually inter- vened, and for good reason. The tools avail- able were challenging to implement and truly required specialty care. Thankfully, the interventional glaucoma revolution has upended this dynamic, allowing for a democratization of care delivery in a way that focuses on patient quality of life. The interventional mindset begins early in the patient journey with the use of appropriate diagnostics and careful examination. When the right patient is identified, the integration of nov- el technologies like drug delivery, standalone microinvasive surgeries, and laser technologies allow for consistent stabilization and reduction of intraocular pressure that is both physiologic and comfortable. Increasing evidence has sug- gested that interventional strategies reduce visu- al field progression and risk of requiring much more aggressive surgical procedures. In this bonus issue of EyeWorld, we delve a bit deeper into the glaucoma paradigm, demon- strating what it looks like now. This space is an exciting and evolving one, as new players on the field like sustained drug delivery pharmaceuti- cals are constantly disrupting the paradigm and empowering more ophthalmologists than ever to serve their patients in a new way. When the right patient is identified, the integration of novel technologies like drug delivery, standalone microinvasive surgeries, and laser technologies allow for consistent stabilization and reduction of intraocular pressure that is both physiologic and comfortable. Valerie Trubnik, MD, EyeWorld Glaucoma Editorial Board member, shared her thoughts on interventional glaucoma: "In the past decade, our glaucoma treatment paradigm has been moving the needle to a more interventional or proactive approach. Due to a plethora of new and emerging MIGS, these pro- cedures are now filling the gap between conservative pharmaceutical man- agement and more invasive filtering/ cycloablative procedures. The benefit of moving toward this approach improves patients' quality of life, diminishes sys- temic and local side effects, improves compliance, and most importantly, decreases the chance for visual decline." INTERVENTIONAL GL AUCOMA

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